MSF medical staff provide care to women with complications during pregnancy at the Gondama Referral Center, in Bo.

Why are we there?

Endemic/epidemic disease

Health care exclusion

Ebola Update

March 17, 2016

On March 17, 2016, Sierra Leone was declared free of Ebola for the second time. The first outbreak in Sierra Leone was declared to have ended on November 7, 2015, but a confirmed death was reported on January 14 and an additional case was identified on January 20.

Vigilance and ability to respond quickly to new possible cases must be maintained. Flare-ups after the end of the epidemic remain a possibility. MSF will maintain an emergency response capacity in the country.

MSF developed activities to treat people who suffered from the virus and continue to provide medical and psychosocial services to some of the country’s 4,000 Ebola survivors in Freetown and Tonkolili District. Non-Ebola health activities in several districts of the country (Kabala, Magburaka, Kenema) have started, as many components of the health system need to be strengthened.

Our Work

There were new Ebola cases in Sierra Leone during 2015, but the World Health Organization declared the outbreak over on 7 November.

MSF continued its Ebola response, and the 100-bed Prince of Wales School Ebola treatment center in Freetown provided medical care and psychological support for Ebola patients until February. Of the 400 patients admitted, 170 were confirmed as having the virus. The team performed triage, isolated and tested patients, and ran health promotion activities.

A specialized unit was opened in Freetown in January to care for pregnant women suffering from Ebola, and for their babies, who are particularly vulnerable to the disease. At the peak of the epidemic, mortality rates for pregnant women reached as high as 90 per cent. Later in the year, the team also began seeing patients who were not pregnant but required medical attention, such as children.

Many Ebola survivors are reporting eye and joint problems, as well as anxiety and depression. In February, MSF opened a survivor clinic in Freetown, where the team provided medical and psychological support, referred patients as necessary and ensured free access to ophthalmic care at the Kissy eye hospital. In July, MSF began providing survivor support in Tonkolili district through mobile clinics, and also started running mobile clinics in Kailahun district in December that offered medical consultations and referrals to mobile eye care clinics managed by Partners in Health for specialized care.

In addition, until the end of May MSF surveillance teams supported the Ministry of Health following up on Ebola alerts and accompanied decontamination outreach teams who worked in the slum areas of Freetown. Their activities played an essential role in infection control. The homes of people suspected of having Ebola were disinfected, hygiene items such as soap and chlorine were distributed, and health promotion messages were shared. MSF also provided personal protective gear such as goggles, surgical masks, gowns and gloves to healthcare workers.

Ebola Project Closures and Handovers

The Kailahun treatment center was closed early in 2015 after Ministry of Health staff received extensive training in biosafety and isolation protocols, the referral process and disease surveillance. An isolation ward was also built before the handover to manage any cases referred from around the district. The Magburaka treatment center closed in May and the Bo center in October.

Tackling Measles and Malaria

During the Ebola outbreak, routine vaccination schedules fell by the wayside, resulting in a resurgence of preventable diseases. In April, MSF responded to a measles outbreak in Freetown and until June teams supported 10 public health units by training staff, supervising case management and donating medication.

MSF also undertook a mass distribution of antimalarials in Western province in January, reaching over 1.8 million people.

Alessandro Siclari/MSF

An MSF Health Outreach Worker explains how to recognize Ebola to children of the community.

At the end of 2015, MSF had 779 staff in Sierra Leone. MSF has worked in the country since 1986.

Patient Story

Jenneba, 26 years old

“This is my third pregnancy. I have had two miscarriages before. Last night I felt pain, so an ambulance picked me up from the health center and took me to Gondama. The nurse in the ambulance held my hand and talked to me nicely during the ride.

The nurses at the hospital examined me and said that I wasn’t in labor yet. I am still in pain and very worried about what is happening. If I lose this baby, I am worried that my husband will leave me.”